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Polypoid melanoma, a virulent variant of the nodular growth pattern
Abstract:
Thirty-two patients who had polypoid melanoma were identified in a registry of 552 melanoma patients. The tumor is regarded as a variant of nodular melanoma and is associated with an increased thickness, more frequent ulceration than the nodular variant of melanoma, younger patient age, and higher probability of occult metastasis. Polypoid melanomas were most frequently present on the trunk, and were also encountered in unusual sites, such as the mucosa of the nose, hard palate, and anorectal junction. In terms of survival, the patients with the polypoid nodular variant fared significantly worse than those with nonpolypoid nodular (P = 0.05) and those with superficial spreading (P = 0.003) melanomas. The five-year survival rate for polypoid variant was 42%, in contrast to 57% for the nonpolypoid nodular and 77% for the superficial spreading melanomas. The poor prognosis of patients who have polypoid melanoma is most likely due to its being the type of melanoma with the deepest penetration at the time of surgical excision.
Insights
Polypoid melanoma, a nodular melanoma variant, presents with deeper tumors and worse survival rates. This aggressive form of melanoma requires careful consideration due to its poor prognosis.
Area of Science:
- Dermatology
- Oncology
Background:
- Polypoid melanoma is a rare variant of nodular melanoma.
- It is characterized by increased thickness, ulceration, younger patient age, and a higher likelihood of metastasis.
Purpose of the Study:
- To investigate the clinical characteristics and survival outcomes of polypoid melanoma.
- To compare polypoid melanoma with other melanoma subtypes.
Main Methods:
- Retrospective analysis of 32 polypoid melanoma cases from a registry of 552 melanoma patients.
- Comparison of survival rates with nonpolypoid nodular and superficial spreading melanomas.
Main Results:
- Polypoid melanomas most commonly occurred on the trunk but were also found in unusual sites like the nasal mucosa and anorectal junction.
- Patients with polypoid melanoma had significantly worse survival rates (42% 5-year survival) compared to nonpolypoid nodular (57%) and superficial spreading (77%) melanomas.
- The poor prognosis is likely due to the deeper tumor penetration at diagnosis.
Conclusions:
- Polypoid melanoma is an aggressive subtype associated with poor prognosis.
- Deeper tumor penetration is a key factor contributing to its poor survival.
- Early detection and aggressive treatment strategies are crucial for managing polypoid melanoma.